Individual provider · Type 1 NPI

Madison Ravine, DPM

Foot & Ankle Surgery Podiatrist · San Diego, CA

NPI number 1679102800 Active

Practice location

3405 Kenyon St Ste 502
San Diego, CA 92110-5008

Call (619) 225-9601 Map

Other practice locations

  • 1493 Cambridge St, Cambridge, MA 02139-1047 · (617) 665-1000

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103X1516 (MA)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1679102800

Madison Ravine, DPM's National Provider Identifier is 1679102800, issued on Apr 8, 2020. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in San Diego, CA. The record was last updated on Mar 6, 2024.